1
|
Romero L, Du Mond J, Carneiro PB, Uy R, Osika J, Wallander Gemkow J, Yang TY, Whitt M, Overholser A, Karasu S, Curtis K, Skapik J. Building Capacity of Community Health Centers to Improve the Provision of Postpartum Care Services Through Data-Driven Health Information Technology and Innovation. J Womens Health (Larchmt) 2024; 33:1140-1150. [PMID: 38990207 PMCID: PMC11377156 DOI: 10.1089/jwh.2024.0364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024] Open
Abstract
Maternal morbidity and mortality remain significant challenges in the United States, with substantial burden during the postpartum period. The Centers for Disease Control and Prevention, in partnership with the National Association of Community Health Centers, began an initiative to build capacity in Federally Qualified Health Centers to (1) improve the infrastructure for perinatal care measures and (2) use perinatal care measures to identify and address gaps in postpartum care. Two partner health center-controlled networks implemented strategies to integrate evidence-based recommendations into the clinic workflow and used data-driven health information technology (HIT) systems to improve data standardization for quality improvement of postpartum care services. Ten measures were created to capture recommended care and services. To support measure capture, a data cleaning algorithm was created to prioritize defining pregnancy episodes and delivery dates and address data inconsistencies. Quality improvement activities targeted postpartum care delivery tailored to patients and care teams. Data limitations, including inconsistencies in electronic health record documentation and data extraction practices, underscored the complexity of integrating HIT solutions into postpartum care workflows. Despite challenges, the project demonstrated continuous quality improvement to support data quality for perinatal care measures. Future solutions emphasize the need for standardized data elements, collaborative care team engagement, and iterative HIT implementation strategies to enhance perinatal care quality. Our findings highlight the potential of HIT-driven interventions to improve postpartum care within health centers, with a focus on the importance of addressing data interoperability and documentation challenges to optimize and monitor initiatives to improve postpartum health outcomes.
Collapse
Affiliation(s)
- Lisa Romero
- CDC, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Jennifer Du Mond
- Department of Clinical Affairs, National Association of Community Health Centers, Bethesda, Maryland, USA
| | - Pedro B Carneiro
- Department of Clinical Affairs, National Association of Community Health Centers, Bethesda, Maryland, USA
| | - Raymonde Uy
- Department of Clinical Affairs, National Association of Community Health Centers, Bethesda, Maryland, USA
| | - Jayson Osika
- Department of Clinical Affairs, National Association of Community Health Centers, Bethesda, Maryland, USA
| | | | | | | | | | | | - Katherine Curtis
- CDC, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Julia Skapik
- Department of Clinical Affairs, National Association of Community Health Centers, Bethesda, Maryland, USA
| |
Collapse
|
2
|
Emanuele E, Minoretti P. Measuring the Impact of Data Sharing: From Author-Level Metrics to Quantification of Economic and Non-tangible Benefits. Cureus 2023; 15:e50308. [PMID: 38205488 PMCID: PMC10777335 DOI: 10.7759/cureus.50308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2023] [Indexed: 01/12/2024] Open
Abstract
In early 2023, the National Institutes of Health (NIH) implemented its Data Management and Sharing (DMS) Policy, requiring researchers to share scientific data produced with NIH funding. The policy's objective is to amplify the benefits of public investment in research by promoting the dissemination and reusability of primary data. Given this backdrop, identifying a robust methodology to assess the impact of data sharing across diverse research domains is essential. In this review, we adopted two methodological paradigms, the bottom-up and top-down strategies, and employed content analysis to pinpoint established methodologies and innovative practices within this intricate field. Although numerous author-level metrics are available to gauge the impact of data sharing, their application is still limited. Non-traditional metrics, encompassing economic (e.g., cost savings) and intangible benefits, presently appear to hold more potential for evaluating the impact of primary data sharing. Finally, we address the primary obstacles encountered by open data policies and introduce an innovative "Shared model for shared data" framework to bolster data sharing practices and refine evaluation metrics.
Collapse
|
3
|
Holmgren AJ, Esdar M, Hüsers J, Coutinho-Almeida J. Health Information Exchange: Understanding the Policy Landscape and Future of Data Interoperability. Yearb Med Inform 2023; 32:184-194. [PMID: 37414031 PMCID: PMC10751121 DOI: 10.1055/s-0043-1768719] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Abstract
OBJECTIVES To review recent literature on health information exchange (HIE), focusing on the policy approach of five case study nations: the United States of America, the United Kingdom, Germany, Israel, and Portugal, as well as synthesize lessons learned across countries and provide recommendations for future research. METHODS A narrative review of each nation's HIE policy frameworks, current state, and future HIE strategy. RESULTS Key themes that emerged include the importance of both central decision-making as well as local innovation, the multiple and complex challenges of broad HIE adoption, and the varying role of HIE across different national health system structures. CONCLUSION HIE is an increasingly important capability and policy priority as electronic health record (EHR) adoption becomes more common and care delivery is increasingly digitized. While all five case study nations have adopted some level of HIE, there are significant differences across their level of data sharing infrastructure and maturity, and each nation took a different policy approach. While identifying generalizable strategies across disparate international systems is challenging, there are several common themes across successful HIE policy frameworks, such as the importance of central government prioritization of data sharing. Finally, we make several recommendations for future research to expand the breadth and depth of the literature on HIE and guide future decision-making by policymakers and practitioners.
Collapse
Affiliation(s)
| | - Moritz Esdar
- University of Applied Sciences Osnabrueck, Germany
| | - Jens Hüsers
- University of Applied Sciences Osnabrueck, Germany
| | | |
Collapse
|
4
|
Sittig DF, Lakhani P, Singh H. Applying requisite imagination to safeguard electronic health record transitions. J Am Med Inform Assoc 2022; 29:1014-1018. [PMID: 35022741 PMCID: PMC9006683 DOI: 10.1093/jamia/ocab291] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/17/2021] [Accepted: 12/29/2021] [Indexed: 02/05/2023] Open
Abstract
Over the next decade, many health care organizations (HCOs) will transition from one electronic health record (EHR) to another; some forced by hospital acquisition and others by choice in search of better EHRs. Herein, we apply principles of Requisite Imagination, or the ability to imagine key aspects of the future one is planning, to offer 6 recommendations on how to proactively safeguard these transitions. First, HCOs should implement a proactive leadership structure that values communication. Second, HCOs should implement proactive risk assessment and testing processes. Third, HCOs should anticipate and reduce unwarranted variation in their EHR and clinical processes. Fourth, HCOs should establish a culture of conscious inquiry with routine system monitoring. Fifth, HCOs should foresee and reduce information access problems. Sixth, HCOs should support their workforce through difficult EHR transitions. Proactive approaches using Requisite Imagination principles outlined here can help ensure safe, effective, and economically sound EHR transitions.
Collapse
Affiliation(s)
- Dean F Sittig
- University of Texas/Memorial Hermann Center for Healthcare Quality & Safety, School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, USA
| | - Priti Lakhani
- Formerly at Office of Electronic Health Record Modernization, U.S. Department of Veterans Affairs, Washington, DC, USA
| | - Hardeep Singh
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
5
|
Utility of an Electronic Health Record Report to Identify Patients with Delays in Testing for Poorly Controlled Diabetes. Jt Comm J Qual Patient Saf 2022; 48:335-342. [DOI: 10.1016/j.jcjq.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/21/2022]
|
6
|
Sampurno F, Kowalski C, Connor SE, Nguyen AV, Acuña ÀP, Ng CF, Foster C, Feick G, Boronat OG, Dieng S, Brglevska S, Ferrante S, Leung S, Villanti P, Moore CM, Graham ID, Millar JL, Litwin MS, Papa N. Knowledge and insights from a maturing international clinical quality registry. J Am Med Inform Assoc 2022; 29:964-969. [PMID: 35048976 PMCID: PMC9006702 DOI: 10.1093/jamia/ocab281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/17/2021] [Accepted: 12/06/2021] [Indexed: 01/22/2023] Open
Abstract
Since 2017, the TrueNTH Global Registry (TNGR) has aimed to drive improvement in patient outcomes for individuals with localized prostate cancer by collating data from healthcare institutions across 13 countries. As TNGR matures, a systematic evaluation of existing processes and documents is necessary to evaluate whether the registry is operating as intended. The main supporting documents: protocol and data dictionary, were comprehensively reviewed in a series of meetings over a 10-month period by an international working group. In parallel, individual consultations with local institutions regarding a benchmarking quality-of-care report were conducted. Four consensus areas for improvement emerged: updating operational definitions, appraisal of the recruitment process, refinement of data elements, and improvement of data quality and reporting. Recommendations presented were drawn from our collective experience and accumulated knowledge in operating an international registry. These can be readily generalized to other health-related reporting programs beyond clinical registries.
Collapse
Affiliation(s)
- Fanny Sampurno
- Corresponding Author: Fanny Sampurno, BA, BSc (Hons), School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria 3004, Australia;
| | | | - Sarah E Connor
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Anissa V Nguyen
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Àngels Pont Acuña
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Chi-Fai Ng
- SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China
| | - Claire Foster
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Günter Feick
- Patient Support Association Bundesverband Prostatakrebs Selbsthilfe, Bonn, Germany
| | - Olatz Garin Boronat
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | | | - Stephanie Ferrante
- Department of Urology, University of Michigan (on behalf of MUSIC), Ann Arbor, Michigan, USA
| | - Steven Leung
- SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Caroline M Moore
- Department of Urology, Division of Surgical and Interventional Science, University College London, London, UK
| | - Ian D Graham
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Jeremy L Millar
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | | |
Collapse
|